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Evidence-Based Practice Recommendations

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Optimizing Opioid Safety and Efficacy

Review your Transcript to view and print your Certificate of Completion.
Your date of completion will be the date (Pacific Time) the course was electronically
submitted for credit, with no exceptions. Partial credit is not available.

The American Society of Interventional Pain Physicians recommends
methadone for use in late stages after failure of other opioid therapy and only by
clinicians with specific training in the risks and uses.

Level of Evidence: Limited (Evidence
is insufficient to assess effects on health outcomes because of limited number of power
studies, large and unexplained inconsistency between higher-quality trials, important
flaws in trial design or conduct, gaps in the chain of evidence, or lack of information
on important health outcomes.)

The American Society of Interventional Pain Physicians asserts that a
robust agreement that is followed by all parties is essential in initiating and
maintaining opioid therapy, as such agreements reduce overuse, misuse, abuse, and
diversion.

Level of Evidence: Fair (Evidence is
sufficient to determine effects on health outcomes, but the strength of the evidence is
limited by the number, quality, size, or consistency of included studies; generalizability
to routine practice; or indirect nature of the evidence on health outcomes.)

According to the American Society of Interventional Pain Physicians,
urine drug testing should be implemented from initiation of treatment with opioids along
with subsequent adherence monitoring, in an in-office setting with immunoassay and
confirmation for accuracy with chromatography in select cases, to identify patients who
are noncompliant or abusing prescription drugs or illicit drugs, and urine drug testing
may decrease prescription drug abuse or illicit drug use when patients are in chronic pain
management therapy.

Level of Evidence: Good (Evidence
includes consistent results from well-designed, well-conducted studies in representative
populations that directly assess effects on health outcomes.)

Despite limited evidence for reliability and accuracy, screening for
opioid use is recommended by the American Society of Interventional Pain Physicians, as it
will identify opioid abusers and reduce opioid abuse.

Level of Evidence: Limited (Evidence is
insufficient to assess effects on health outcomes because of limited number of power
studies, large and unexplained inconsistency between higher-quality trials, important flaws
in trial design or conduct, gaps in the chain of evidence, or lack of information on
important health outcomes.)

The American Society of Interventional Pain Physicians recommends
titration of long-acting opioids should be carried out with caution.

Level of Evidence: Good (Evidence
includes consistent results from well-designed, well-conducted studies in representative
populations that directly assess effects on health outcomes.)

The American Society of Interventional Pain Physicians asserts that
constipation should be closely monitored in patients prescribed opioids and a bowel
regimen be initiated as soon as deemed necessary.

Level of Evidence: Good (Evidence
includes consistent results from well-designed, well-conducted studies in representative
populations that directly assess effects on health outcomes.)

The Institute for Clinical Systems Improvement recommends that opioid
prescribers should recognize the symptoms of opioid use disorder, understand the treatment
options for opioid use disorder, and have a referral source available.

Review your Transcript to view and print your Certificate of Completion.
Your date of completion will be the date (Pacific Time) the course was electronically
submitted for credit, with no exceptions. Partial credit is not available.